Download NURS 5334 Final Exam Pharm Exam ALL 500 QUESTIONS AND DETAILED SOLUTIONS LATEST UPDATE THI and more Exams Nursing in PDF only on Docsity!
NURS 5334 Final Exam Pharm Exam ALL 500
QUESTIONS AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR
Erik presents with one golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive treatment. Which medication would be the best choice for treatment? Bacitracin + Polymyxin B (generic double antibiotic treatment) The most cost-effective treatment for two or three impetigo on the face is Mupirocin ointment Topical immunomodulators such as pimecrolimus (Elidel)or tacrolimus (Protopic) are used for Short-term or intermittent treatment of atopic dermatitis This child scratches a lot! There is a family history of both asthma and hay fever. Which medication should be used? Hydrocortisone 1% ointment 2x/day A patient became photosensitive after taking an antibiotic; she was most likely taking... Tetracycline Treatment for rosacea may include all of the following medications except: Glucocorticoids Jim presents with a fungal infection of two of his toenails (onychomycosis). Treatment for fungal infections of the nail includes:
Oral Terbinafine What is the mechanism of action of cyclosporine? Calcineurin inhibitor Which of the following immunosuppressant medications avoids the need for therapeutic monitoring? Mycophenolate mofetil (Cellcept) What is true regarding EC? Levonorgestrel will not disrupt an existing pregnancy. Tobie presents to the clinic with moderate acne. He has been using OTC Benzoyl Peroxide at home with minimal improvement. A topical antibiotic (clindamycin) and a topical retinoid adapalene (Differin) are prescribed. Education of Tobie would include... He may see an initial worsening of acne that will improve in 6 to 8 weeks. Mild to moderate acne may be initially treated with... Topical retinoid Long-term treatment of moderate atopic dermatitis iclude: Topical corticosteroids and emollients Instructions for the use of Selenium Sulfide shampoo (Selsun) to treat scalp seborrhea include: Shampoo twice a week for 2 weeks then weekly. When prescribing topical acyclovir for treatment of herpes labialis (cold sores), patient education would include
Increased risk of venous thromboembolism What advice would you give to a woman who has missed 1 active combined OC pill? Take the missed pill right away; no backup method is needed Which of the following drugs may reduce OC efficacy? Isotretinoin At what age threshold is OC use contraindicated in women who smoke? 35 years and older What is true of the copper IUD? Cramping and irregular bleeding are common side effects What EC is associated with the most side effects? Yuzpe regimen Which of the following ECs is FDA approved for use up to 120 hours after unprotected intercourse? Ella Loperamide (Imodium) inhibits peristalsis by a direct effect on the circular and longitudinal muscles of the intestinal wall. It also reduces fecal volume, increases viscosity and bulk, and diminishes the loss of fluid and electrolytes. However, its great advantage as an antidiarrheal over the old use of opiates is that it... has no side effects attributed to taking opiates, such as euphoria and addiction Classes of drugs used in the treatment of GERD
H2 blockers, Cytoprotective agents, Antacids By how much do PPIs reduce gastric acid? More than 90% What agent would you suggest to help someone with a mild case of constipation? Docusate (colace) If a patient asks how does the 5HT receptor antagonist ondansetron (Zofran) act on the body to stop the nausea of cancer chemotherapy, you can simply state that it is an agent that is able to... Block central nervous system trigger zones so that nausea cannot be induced. Patients commonly take PPIs for long periods and way beyond recommended use for treating a peptic ulcer. The FDA has determined that people who take them continuously for as long as a year are subject to... Increased fractures of wrist, hip, and spine What drug should not be administered for more than 6 weeks because it is an agent of high risk for inducing extrapyramidal symptoms? Metoclopramide (Reglan) A 45-year-old man with a duodenal ulcer was treated with a combination of drugs to heal the mucosal damage and to eradicate Helicobacter pylori. Which of the following antibacterial drugs is used commonly to eradicate intestinal Helicobacter pylori? Clarithromycin A patient is receiving highly emetogenic chemotherapy for metastatic carcinoma. to prevent chemotherapy-induced nausea and vomiting, she is likely to be treated with what?
A 24-year-old woman has returned from a vacation abroad suffering from traveler's diarrhea, and her problem has not responded to antidiarrheal drugs. A pathogenic gram (-) bacillus is suspected. Which drug is most likely to be effective in the treatment of this patient? Ciprofloxacin Which statement about the fluoroquinolones is accurate? Have different therapeutic applications depending on the generation. Which adverse effect is most likely to occur with sulfonamides? Skin reactions Which statement about ciprofloxacin is accurate? During treatment, tendonitis and even tendon rupture may occur The primary reason for the use of drug combinations in the treatment of tuberculosis is to Delay or prevent the emergence of resistance Which statement about fluconazole is accurate? Primary route of elimination is renal. You have received the culture and sensitivity report from the lab. The patient's urine is growing E-coli, and the following is reported. Ampicillin: MIC 38 ug/ml Gentamicin MIC 20 ug/ml Piperacillin MIC 4 ug/ml Ciprofloxacin MIC 2.5 ug/ml Which medication would be the most appropriate to prescribe? Ciprofloxacin
A 55-year-old man who has been on anticoagulation treatment for many years is diagnosed with TB. Which of the following antimycobacterial agents would most likely induce cytochrome P450 enzymes in a patient's liver and thereby modify the effects of his anticoagulant treatment? Rifampin Which drug is an antiviral that can be used to treat herpes simplex virus? Acyclovir What describes the mechanism of action of Oseltamivir (Tamiflu)? Selectively inhibits neuraminidase First generation cephalosporins are best used against which of the following organisms? Gram (+) cocci Isoniazid can cause serious adverse effects including... Hepatitis, peripheral neuropathy, seizures The cephalosporin cefepime is eliminated via tubular secretion and/or glomerular filtration What is a common adverse effect of sulfamethoxazole with trimethoprim (cotrimoxazole or Bactrim)? Skin reactions What describes the mechanism of action of ethinyl estradiol in oral contraceptives? Inhibits release of follicle-stimulating hormone
MMR (Measles, Mumps, Rubella) Explanation: MMR is a live vaccine and should not be used in these populations." Which emergency contraceptive can be used up to 5 days after unprotected intercourse? Ulipristal Explanation: Ulipristal is a selective progesterone receptor modulator and remains effective up to 120 hours." Which antacid combination is designed to minimize gut motility side effects? Maalox (aluminum + magnesium) Explanation: Aluminum causes constipation and magnesium causes diarrhea, balancing each other." Which H2 blocker is known for significant drug interactions due to CYP450 inhibition? Cimetidine Explanation: Cimetidine inhibits CYP450 and interacts with warfarin, phenytoin, and theophylline." What is a common adverse effect of long-term PPI use? Osteoporosis Explanation: PPIs reduce calcium absorption and increase fracture risk with prolonged use." Misoprostol is contraindicated in pregnancy due to what risk? Uterine contractions and miscarriage Explanation: Misoprostol is a prostaglandin analog and can induce labor or miscarriage."
Which antiemetic is a 5-HT3 receptor antagonist used for chemotherapy-induced nausea? Ondansetron Explanation: Ondansetron blocks serotonin receptors in the CTZ and GI tract." What is the mechanism of action of beta-lactam antibiotics? Inhibit bacterial cell wall synthesis Explanation: Beta-lactams bind PBPs, preventing peptidoglycan cross-linking." What is a major risk when combining vancomycin with aminoglycosides? Nephrotoxicity Explanation: Both drugs are nephrotoxic and should be used cautiously together." Which class of antibiotics is known to cause tendon rupture? Fluoroquinolones Explanation: They have a black box warning for tendon rupture, especially in older adults." What antibiotic is preferred orally for treating C. difficile infection? Vancomycin Explanation: Oral vancomycin is not absorbed and acts directly in the gut lumen." Which antifungal class inhibits ergosterol synthesis? Azoles Explanation: Azoles block fungal CYP enzymes involved in ergosterol biosynthesis." Which live vaccine is contraindicated in pregnancy?
Osteoporosis prevention Explanation: Raloxifene is a SERM that acts as an estrogen agonist in bone." What drug is first-line for bacterial vaginosis? Metronidazole Explanation: It is effective against anaerobes like Gardnerella vaginalis." Which emergency contraceptive is most effective within 5 days? Copper IUD Explanation: The copper IUD prevents implantation and is the most effective method post- intercourse." What hormone dominates the luteal phase of the menstrual cycle? Progesterone Explanation: Progesterone prepares the endometrium for potential implantation." What topical is best for dry, scaly skin? Ointment Explanation: Ointments are occlusive and lock in moisture." What is a serious side effect of isotretinoin? Teratogenicity Explanation: It can cause severe birth defects; pregnancy must be avoided." Which sunscreen protects against both UVA and UVB?
Broad-spectrum SPF 30+ Explanation: Broad-spectrum sunscreens provide comprehensive UV protection." What is a common topical for rosacea? "B. Metronidazole cream Explanation: It reduces inflammation and redness in mild to moderate cases." Which agent is used topically for verruca (warts)? Salicylic acid Explanation: Salicylic acid exfoliates and destroys wart tissue." Which laxative is safest for long-term use in pregnancy? Psyllium (bulk-forming) Explanation: Bulk-forming laxatives are not absorbed and are safe in pregnancy." Metoclopramide should be avoided in patients with which condition? Parkinson's disease Explanation: It can worsen extrapyramidal symptoms due to dopamine antagonism." Which drug is a cytoprotective agent forming a physical barrier over ulcers? Sucralfate Explanation: Sucralfate binds ulcer bases, protecting them from acid." Bismuth subsalicylate is contraindicated in children due to risk of: Reye’s syndrome
Which vaccine is given intradermally and protects against tuberculosis? BCG vaccine Explanation: BCG induces T-cell mediated immunity against TB." What is a key adverse effect of mTOR inhibitors like sirolimus? Hyperlipidemia Explanation: These drugs can cause elevated lipid levels and mouth ulcers." What does abatacept block to inhibit T-cell activation? CD28-CD80/86 costimulation Explanation: Abatacept prevents T-cell activation by blocking this interaction." What is a serious risk associated with monoclonal antibodies like rituximab? Infusion reactions Explanation: These drugs can cause cytokine-release symptoms during infusion." Corticosteroids like prednisone can cause which common long-term side effect? Osteoporosis Explanation: They impair bone metabolism, increasing fracture risk." Which contraceptive option has the highest user-independence and long duration? IUD (levonorgestrel or copper) Explanation: IUDs are long- acting reversible contraceptives effective for 3–10 years." Estrogen therapy is contraindicated in women with which condition?
History of thromboembolism Explanation: Estrogen increases clotting risk, especially in high-risk patients." What non-hormonal option can help with hot flashes during menopause? SSRIs (e.g., paroxetine) Explanation: SSRIs are effective alternatives when HRT is contraindicated." Progestin-only pills must be taken: At the same time every day Explanation: Strict adherence is critical to maintain efficacy." Which hormone surges to trigger ovulation mid-cycle? Luteinizing hormone (LH) Explanation: The LH surge around day 14 causes ovulation." Which topical is best for scalp conditions like psoriasis or seborrhea? Solution Explanation: Solutions spread easily through hair and are less greasy." Topical steroids should be used cautiously on the face due to risk of: Skin atrophy Explanation: Facial skin is thin and prone to steroid-induced thinning." Which topical is a calcineurin inhibitor used for eczema? Tacrolimus
QUESTION: Why would you give a patient Naltrexone for maintenance once they recovered from opioid abuse? - ANSWER-Naltrexone is a opioid antagonist that blocks the euphoric and sedative effects of opioids. QUESTION: What are 3 side effects of Hydrocodone? - ANSWER-Constipation Respiratory depression Addition QUESTION: What's the MOA of Sumatriptan? (-triptan) - ANSWER-Selective agonist for serotonin 5HT receptors on intracranial blood vessels and sensory nerves of the trigeminal system, causes VASOCONSTRICTION and reduces neurogenic inflammation QUESTION: What is the supplement Feverfew used for? - ANSWER-Migraine Prophylaxis QUESTION: Which types of drugs cannot be combined with Feverfew? - ANSWER-Antiplatlets Anticoagulants Increased risk of bleeding in patients taking antiplatelets (Aspirin) and anticoagulants (Wafarin) QUESTION: How much Folic acid need to be given for a Folic Acid Deficiency? - ANSWER-Give 1- 2mg/day PO for a deficiency
QUESTION: How much folic acid should a woman of child bearing age take? - ANSWER- 400 - 800 mcg daily QUESTION: How much folic acid is recommended for a pregnant women? - ANSWER- 400 - 600 mcg/day QUESTION: If a patient comes in using Tacrolimus and Pimecrlimus cream, what is this for? - ANSWER-Atopic Dermatitis (Eczema) QUESTION: Ace inhibitors are contraindicated in pregnancy. While treatment of heart failure during during pregnancy is best done by a special, which of the following drug classes are considered to be safe at least in the later parts of pregnancy? A. Diuretics B. ARBS C. Beta blockers D. Nitrates - ANSWER-C. Beta blockers QUESTION: What are the names of two medications that are safe for pregnant women? - ANSWER-Methyldopa and Labetalol are the traditional agents of choice for pregnant women
